1. Field of the Invention
The invention pertains in general to a device for maintaining and positioning limbs during surgical procedures and in particular to a device for maintaining and positioning an arm during arthroscopy.
2. Description of the Prior Art
Arthroscopy is a surgical procedure which permits a physician to examine the inside of joints such as the knee, shoulder and ankle. During the arthroscopic procedure, a small incision is made near the joint to be examined, and an arthroscope, which is a thin illuminated viewing scope with optical fibres on its tip, is inserted through the incision and is threaded into the joint by the physician. With the arthroscope, the physician can directly view the interior portion of the joint to assess the extent of damage and develope a plan of treatment.
During the threading process, the limb must often be rotated to permit the physician to thread the arthroscope to the joint to be examined. Furthermore, particularly with respect to shoulder arthroscopy, it is often necessary to position and maintain the patient's limb in a position above and away from the patient's body.
In the prior art, the patient's limb is maintained in a desired position during arthroscopy by affixing the limb to an external support such as a pole or stand, usually by tying the limb to the external support with supporting mechanisms such as tapes, ropes or straps. The process of attaching the tapes, ropes or straps to the patient's limb, and positioning the limb with the external support is a time consuming and cumbersome process resulting in a lengthy pre-operative set up period. The pre-operative set up period is lengthy in part because care must be taken to adequately support the limb without constricting its blood flow.
Furthermore, because an incision is made as part of the arthroscopic procedure, there is a need for sterilization in the field of operation. In the prior art, this meant that in addition to taping, roping or strapping the limb in the desired position, it was necessary to sterilize the field by either utilizing sterile support mechanisms and/or by wrapping the support mechanisms with sterile pads or towels. This also increases the pre-operative set up period.
In a typical prior art pre-operative set up procedure, the patient's limb is lifted to the approximate position. The limb is then sterilized with a sterilizing solution and is then draped with a sterile pad or towel. Next, the tape, rope or strap is affixed to the limb and the limb is in turn affixed to the external support.
In addition to the lengthy and cumbersome pre-operative set up procedure, the prior art also suffers from the limitation that often two or more of the surgical personnel are required to complete the set up procedure. A further limitation of the prior art procedure is that limbs wrapped with sterile pads or towels cannot be examined during the arthroscopic operation. Furthermore, it is also difficult to reposition or readjust the limb either during the operation or post-operatively.
Attempts have been made in the prior art to provide devices for supporting a patient's arm during shoulder arthroscopy. U.S. Pat. No. 4,628,911, issued Dec. 16, 1986 to Bornstein, discloses an arm suspension mitt for immobilizing and positioning a patient's arm for shoulder arthroscopy. While the above-cited reference represents an advance over the prior art, it does not completely fulfill the needs of the art because it does not allow for individual adjustment of the tension along each finger and thumb and further does not allow for the transfer of forces from the distal end of the fingers and thumb to the wrist in order to provide adequate support for the arm during arthroscopy without constricting the blood flow to the arm. Furthermore, the Bornstein reference requires inflation of an inflatable chamber and does not provide an effective means for easily repositioning the arm once the arm is suspended.
A need remains in the art for a support for limbs during arthroscopy which minimizes the pre-operative set up period, limits the number of surgical personnel necessary to perform the pre-operative set up, is fully adjustable during the operation and post-operatively, permits inspection of the limb while supported, permits quick and easy repositioning of the limb once the limb is suspended and which maintains a sterile operative field.